| NPI | 1629336664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRIY VOLOTSENKO Owner 212-781-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 047879) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 052869) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |